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Type 2 Diabetes - Coggle Diagram

- - - - As insulin secretion increases beta cells become exhausted which leads to insulin deficiency
        
        As the exhaustion off the beta cells continue they began to deteriorate until the production of insulin is ceased
        
        Insulin resistance combined with the presence of lipid and thrombotic abnormalities and atherosclerotic risk factors determines cardiovascular risk; increased cardiovascular risk begins before hyperglycemia, possibly because of insulin resistance.
        
        Beta-Cells compensate to restore glucose hemostasis
        
        Glucotoxicity: high level of sugar build up in the blood
        
        Consistent missed blood glucose testing coupled with lack of appropriate insulin administration
        
        Consistently high blood glucoses leading to elevated HgA1/Cs leading to worsened physiological responses.
        
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        Resulting in elevated glucose levels up to 148 by attaching themselves to Hgb
        
        Abnormal glucose tolerance occurs, and postprandial blood glucose levels increase; hepatic gluconeogenesis suppression fails, and fasting hyperglycemia develops.
        
        High blood sugar can result in damage to blood vessels.
        
        High levels of glucose in the blood can possibly result in plaque buildup.
        
        This plaque buildup can make it extremely difficult for blood to pump properly.
        
        Overtime, this bloodflow issue can result in damage to small blood vessels that are responsible for supplying nerves in the body.
        
        The use of metformin could be used to help control high glucose levels more preventing the plaque build up on arterial walls.
        
        Patient's fasting blood sugar test is132 mg/dL
      - Insulin resistance elevates levels of free fatty acids in plasma, leading to decreased glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat.
        
        Beta cells don't recognize high blood glucose which leads to decreased insulin secretion
        
        This increase in the release of fat can lead to an increase of plaque on arterial walls which can be released into the blood to in creased LDL and a low HDL in a blood test
        
        High LDL (bad), and a low HDL (good), indicates poor lifestyle choice or improper management of their glucose which can lead to built up plaque on arterial walls leading to hypertension and CAD
        
        Medication such as statins or specifically Atorvastatin can treat high cholesterol levels and triglycerides levels through inhibiting the enzyme HMG-CaA. This medication could lower LDL and increase HDL
- - - - One of the most common precursors for osteomyelitis and foot amputation in lower extremities
      - This condition is typically treated with combined intervention of multiple physicians including podiatrists, vascular surgeons, endocrinologists, and infectious disease specialists.
- - - - Leads to salt and water retention, raising blood pressure
        
        Which can put the patient at 50% more risk of developing open angled glaucoma from optic nerve changes (George already has been diagnosed with Open Angle Glaucoma)
        
        Pt's HgA1C is an 8 and glucose level is at 148 which means poor regulation of glucose levels leading to open angled glaucoma from optic nerve changes
        
        Open angle glaucoma manifests in forms of eye pain and pressure, headaches, red eyes, low vision, blurred vision, narrowed vision, or tunnel vision. (George is exhibiting blurred vision)
        
        Treated with prostaglandin analogs like latanoprost, bimatoprost, and travoprost (in George's case latanoprost)
        
        Patient's lab values for BUN and Creatinine are both elevated meaning kidneys are not working the best.
        
        BUN level is at 29 and creatine is at 1.3 is on the higher side which may indicate malnutrition along with diminished kidney function
        
        The uses of a diuretic or what some people call a water pill could help decrease the water retention in the body which could lower blood pressure as the amount of water or fluid in the body is decreased
      - HgA1C is at 8 showing long term elevated sugar levels because of poor diet or malnutrition
    - - Patient's BP is 165/95 with an elevated heart rate(92) which is indicative of diabetes related heart issues
        
        Hydrochlorothiazide for patient's hypertension--transported from the circulation into epithelial cells of the distal convoluted tubule by the organic anion transporters OAT1, OAT3, and OAT4.
        
        Furosemide promotes diuresis by blocking tubular reabsorption of sodium and chloride in the proximal and distal tubules, as well as in the thick ascending loop of Henle.
        
        This can interact with the potassium, potentially lowering his potassium serum level. Which could make sense because his K lab came back at a 3.3 mEq/L which is lower than the normal 3.5-5.0 mEq/L
      - A antihypertension medication such as metropolol is used to lower blood pressure and allow the vessels to constrict or dilate as they once did before.